Sunnyside Medical Office PC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

SUNNYSIDE MEDICAL OFFICE PC

Practice address

4510 Skillman Ave
Sunnyside, NY 11104-2117

Phone

(718) 383-1010

Fax

(718) 383-1114

NPI assigned

Apr 10, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gil A Ruiz

Title

Executive President

Phone

(718) 383-1010

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428624000000",
    "number": "1437545944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 SKILLMAN AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111042117",
            "telephone_number": "718-383-1010",
            "fax_number": "718-383-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 SKILLMAN AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111042117",
            "telephone_number": "718-383-1010",
            "fax_number": "718-383-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE MEDICAL OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-10",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "GIL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE PRESIDENT",
        "authorized_official_telephone_number": "718-383-1010"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Sunnyside, NY
• Providers in Sunnyside, NY by specialty
• Point of Service in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.